Construction of a Spatial Equalization Assessment System for Medical Facilities
Abstract
:1. Introduction
2. Methods and Data
2.1. Research Methods
- Focus group method
- Exploratory factor analysis (EFA)
- Multiple linear regression
2.2. Screening of Factors Influencing Spatial Equilibrium in Hospital Buildings
2.2.1. Data Extractions
- Functional cluster dimension
- Dimensionality of a single entity
- Regional planning dimension
2.2.2. Specific Operations
2.3. Scale Creation for the Extraction of Indicators of Spatial Balance
2.3.1. Research Objective
2.3.2. Statistical Methods
2.3.3. Calibration Tools
2.3.4. Scale Creation
2.4. Extraction of Equilibrium Indicators
2.4.1. Design of Questionnaires
2.4.2. Sample Features
2.4.3. Analysis of Entries
2.4.4. Exploratory Factor Analysis (EFA)
- The factor’s eigenvalue must be greater than 1.
- Each factor has at least three entries.
- The item’s maximum loading value on both dimensions is greater than 0.4 and the difference is less than 0.1.
- The factor loadings of the dimension where the item is located are lower than 0.4.
2.4.5. Validation of Indicators
- Structural validity
- Convergent validity
- Distinguishing validity
- Establishment of indicators
3. Results and Discussion
3.1. Spatial Equilibrium Measurement Model Construction for Hospital Buildings
3.1.1. Variable Selection
3.1.2. Model Construction
3.2. Spatial Balance Evaluation Rating for Hospital Buildings
3.3. Comparison of Research Results
4. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Tier 1 Composition | Tier 2 Composition | Factors Influencing Spatial Equilibrium |
---|---|---|
Regional planning | Quota | Number of hospitals in the region |
Number of people in the region | ||
Number of hospital beds | ||
Site selection | Distance to medical care | |
Relevance among hospitals | ||
Scope of Coverage | ||
Hospital building levels | Environment | Parking spaces |
Barrier-free design | ||
Environmental healing capabilities | ||
Kinetic organization | Efficiency of rescue and treatment | |
Differentiation of streamlines | ||
Function setting | Hospital level | |
Spatial resilience | ||
Type of function | ||
Spatial scale |
Serial Number | Deterministic Value | p | Correlation Coefficient | Cronbach’s A | Remark |
---|---|---|---|---|---|
T1 | 5.984 | 0.000 | 0.454 ** | 0.887 | reservation |
T2 | 7.000 | 0.000 | 0.553 ** | 0.885 | reservation |
T3 | 6.034 | 0.000 | 0.502 ** | 0.886 | reservation |
T4 | 6.153 | 0.000 | 0.480 ** | 0.886 | reservation |
T5 | 5.179 | 0.000 | 0.443 ** | 0.887 | reservation |
T6 | 6.827 | 0.000 | 0.510 ** | 0.886 | reservation |
T7 | 6.309 | 0.000 | 0.559 ** | 0.885 | reservation |
T8 | 5.596 | 0.000 | 0.580 ** | 0.884 | reservation |
T9 | 7.839 | 0.000 | 0.605 ** | 0.884 | reservation |
T10 | 7.319 | 0.000 | 0.620 ** | 0.884 | reservation |
T11 | 7.425 | 0.000 | 0.572 ** | 0.885 | reservation |
T12 | 7.632 | 0.000 | 0.606 ** | 0.884 | reservation |
T13 | 6.809 | 0.000 | 0.575 ** | 0.884 | reservation |
T14 | 6.030 | 0.000 | 0.586 ** | 0.884 | reservation |
T15 | 6.712 | 0.000 | 0.590 ** | 0.884 | reservation |
T16 | 6.512 | 0.000 | 0.597 ** | 0.884 | reservation |
T17 | 2.311 | 0.024 | 00.150 | 0.893 | exclude |
T18 | 3.767 | 0.000 | 0.343 ** | 0.889 | reservation |
T19 | 5.025 | 0.000 | 0.486 ** | 0.886 | reservation |
T20 | 5.727 | 0.000 | 0.539 ** | 0.885 | reservation |
T21 | 5.319 | 0.000 | 0.499 ** | 0.886 | reservation |
T22 | 3.641 | 0.001 | 0.408 ** | 0.888 | reservation |
T23 | 5.276 | 0.000 | 0.514 ** | 0.886 | reservation |
T24 | 5.717 | 0.000 | 0.542 ** | 0.885 | reservation |
T25 | 2.663 | 0.010 | 0.334 ** | 0.890 | exclude |
T26 | 3.618 | 0.001 | 0.386 ** | 0.888 | reservation |
T27 | 3.434 | 0.001 | 0.252 ** | 0.889 | reservation |
T28 | 2.057 | 0.044 | 0.195 * | 0.891 | exclude |
T29 | 2.747 | 0.008 | 0.246 ** | 0.890 | exclude |
T30 | 2.830 | 0.006 | 0.233 ** | 0.891 | exclude |
T31 | 4.920 | 0.000 | 0.437 ** | 0.887 | reservation |
T32 | 5.165 | 0.000 | 0.494 ** | 0.886 | reservation |
T33 | 6.021 | 0.000 | 0.512 ** | 0.886 | reservation |
T34 | 6.302 | 0.000 | 0.504 ** | 0.886 | reservation |
T35 | 2.407 | 0.019 | 0.194 * | 0.891 | exclude |
T36 | 2.854 | 0.006 | 0.261 ** | 0.890 | exclude |
KMO Quantity of Sampling Suitability | 0.890 | |
---|---|---|
Bartlett’s sphericity test | rough chi-square | 2689.744 |
degrees of freedom | 325 | |
significance | 0.000 |
Serial Number | Ingredients | |||
---|---|---|---|---|
1 | 2 | 3 | 4 | |
T10 | 0.873 | |||
T13 | 0.855 | |||
T12 | 0.854 | |||
T15 | 0.851 | |||
T8 | 0.847 | |||
T16 | 0.844 | |||
T11 | 0.826 | |||
T9 | 0.824 | |||
T14 | 0.804 | |||
T1 | 0.872 | |||
T3 | 0.868 | |||
T2 | 0.846 | |||
T5 | 0.833 | |||
T4 | 0.826 | |||
T6 | 0.820 | |||
T7 | 0.802 | |||
T19 | 0.865 | |||
T21 | 0.863 | |||
T24 | 0.860 | |||
T20 | 0.853 | |||
T22 | 0.851 | |||
T23 | 0.817 | |||
T34 | 0.894 | |||
T31 | 0.889 | |||
T33 | 0.870 | |||
T32 | 0.846 |
Fitness Index | X2/df | RMR | RMSEA | CFI | TLI | IFI | GFI |
---|---|---|---|---|---|---|---|
Fitting values | 1.161 | 0.048 | 0.024 | 0.990 | 0.989 | 0.990 | 0.918 |
Dimension | AVE | CR |
---|---|---|
Site selection | 0.656 | 0.93 |
Function setting | 0.637 | 0.94 |
Kinetic organization | 0.634 | 0.912 |
Environment | 0.634 | 0.874 |
Site Selection | Function Setting | Kinetic Organization | Environment | |
---|---|---|---|---|
Site selection | 0.810 | |||
Function setting | 0.147 | 0.798 | ||
Kinetic organization | 0.170 | 0.198 | 0.796 | |
Environment | 0.125 | 0.103 | 0.185 | 0.796 |
Dimension | Subject | Weights | Interpretation of Indicators |
---|---|---|---|
Site selection | Distance to hospital | 0.139 | The greater the distance, the lower the grade; ideally, general hospitals should be reachable by car in thirty minutes, and primary healthcare facilities should be reachable on foot in fifteen minutes. |
Convenience of referrals | 0.145 | The ease of referral routes to upper (lower) level hospitals that facilitate prompt referral is preferred; otherwise, the larger the gap, the lower the rank. The availability of ambulance vehicles in the hospital area is also preferred. | |
Coverage | 0.143 | In other words, the larger the gap, the lower the grade. General hospitals are able to efficiently connect medical services with the primary healthcare institutions under their control, and the primary healthcare institutions are able to meet all community health services with superior focus, covering more than three kilometers. | |
Surrounding transportation convenience | 0.142 | The wider the gap, the lower the grade; alternatively, convenient public transportation in the area and a direct rail connection to the compound are preferred. | |
Building site reserved for future development | 0.147 | This considers whether any land in the hospital’s vicinity has been set aside for development and construction, and how the grade is determined based on that area while also considering the hospital’s present state. | |
Reserve land for emergencies | 0.147 | If a site is successfully integrated with the infectious disease area and the hospital area is designated for emergency medical care, it receives a higher grade; if not, it receives a lower grade. | |
Site area | 0.137 | The larger the gap, the lower the grade; therefore, it is better to have a hospital that serves medical needs without placing undue strain on the surrounding land and environment. | |
Function setting | Hospital level | 0.113 | Level 3A hospitals are preferred (and so on, in descending order), based on the hospital’s rating. |
Emergency transition space | 0.111 | The hospital has areas such as wards, labs, operating rooms, and so on that can be temporarily converted in an emergency. The more areas that can be used for this purpose, the higher the grade. | |
Daily clinic volume | 0.110 | Preferably, general hospitals should have more than 1000 outpatient visits per day. | |
Function type | 0.113 | All three of the aforementioned aspects are deemed to be excellent, failing which they will be eliminated one-by-one. Functional rooms are fully furnished and have room set aside for emergencies, and the functional settings satisfy hospital-level functional requirements. | |
Functional partition | 0.112 | Functional zoning is clearly established, along with the hospital area’s superior efficiency of medical services, as opposed to the principle that the wider the gap, the lower the grade. | |
Orientation of wards and consultation rooms | 0.110 | It is ideal if 80% of the wards and consultation rooms face south; if not, the impact on medical operations and the amount of light in the wards and consultation rooms are determining factors. | |
Web-based consultation services | 0.113 | The higher the rank, the more online medical service items (e.g., online booking, online billing, online consultation, hospital ward registration, and so on) that are offered. | |
Corridor dimensions | 0.108 | To meet the superior standard, waiting areas should accommodate patient needs for consultation and treatment, as well as wheelchair mobility. The larger the gap, the lower the rating. | |
Functional room scales | 0.109 | Based on meeting the regulated area, the higher the grade, the more effectively it is used. | |
Kinetic organization | Functional streaming | 0.160 | The hospital area features distinct areas for outpatient care, emergency care, medical examinations, maternity and child healthcare, wards, infectious disease control, and other functions of the diversion line or entrance. The more gaps there are in the function of the exhaustive flow line, the worse the grade will be. |
Time from admission to consultation | 0.160 | The sooner a patient is seen, the better; general hospitals want to see them within 30 min of admission and primary care organizations within 10. The larger the gap, the lower the grade. | |
Pedestrian–vehicle separation | 0.171 | It is preferable to have distinct pedestrian and vehicle flow lines with distinct lanes for each type of traffic; otherwise, the grade will be lower when the gap is larger. | |
Patient–doctor triage | 0.172 | There is never a perfect point where patient flow and healthcare workers meet; there are some places where staff-only access is advantageous, and vice versa. | |
Clean-sewage diversion | 0.168 | Using smart rail logistics vehicles may vary, depending on the situation. No crossing of personnel and dirt flow lines is excellent; some crossing of personnel and dirt flow lines is good, and vice versa. | |
Ease of access to the medical process | 0.170 | According to the medical treatment flow, everything goes smoothly, every area is understood, and less folding is preferred—the larger the gap, the worse the grade. | |
environment | Aboveground parking setup | 0.248 | Temporary parking spaces, parking spaces for emergency vehicles, staff parking spaces, patient parking spaces, parking spaces for logistics vehicles, and temporary parking spaces (or set up in the underground), along with the hospital area of vehicles parked in an orderly manner, are required for the organization of the best outcome, or else decreasing one by one. |
Accessible design | 0.241 | Facilities free of barriers, such as elevators, accessible restrooms, barrier-free ramps, and barrier-free handrails, are arranged well or excellently; the more gaps, the worse the grade. | |
Healing space setting | 0.254 | According to real senses, each room should have a comfortable and balanced temperature; if not, the rating will be lower. | |
Number of entrances and exits | 0.257 | To meet the preferred standard, general hospitals should have three entrances and exits; otherwise, the larger the gap, the lower the grade. |
Site Selection | Function Setting | Kinetic Organization | Environment | Spatial Equilibrium of Hospital Buildings | |
---|---|---|---|---|---|
Site selection | 1 | ||||
Function setting | 0.140 * | 1 | |||
Kinetic organization | 0.160 ** | 0.186 ** | 1 | ||
Environment | 0.115 | 0.094 | 0.165 ** | 1 | |
Spatial equilibrium of hospital buildings | 0.473 ** | 0.366 ** | 0.393 ** | 0.400 ** | 1 |
Square Sum | Degrees of Freedom | Equalize the Square | F | Significance | |
Regression | 143.831 | 4 | 35.958 | 63.520 | 0.000 |
Residuals | 159.071 | 281 | 0.566 | ||
Total | 302.901 | 285 |
Unstandardized Coefficients | Standardized Coefficient | t | Significance | Covariance Statistics | |||
---|---|---|---|---|---|---|---|
B | Standard Errors | Beta | Tolerances | VIF | |||
(Constant) | −1.450 | 0.372 | −3.900 | 0.000 | |||
site selection | 0.385 | 0.046 | 0.367 | 8.300 | 0.000 | 0.955 | 1.047 |
Function setting | 0.265 | 0.049 | 0.242 | 5.451 | 0.000 | 0.950 | 1.053 |
Kinetic organization | 0.255 | 0.048 | 0.241 | 5.363 | 0.000 | 0.929 | 1.076 |
Environment | 0.286 | 0.043 | 0.295 | 6.698 | 0.000 | 0.962 | 1.040 |
R | R-Square | Adjusted R-Square | Errors in Standardized Estimates |
---|---|---|---|
0.689 | 0.475 | 0.467 | 0.752 |
Level | Level Description | Point Value |
---|---|---|
A | Excellent: the hospital building units that have been evaluated effectively fulfill the requirement for spatial balance with respect to site environment, flow organization, functional settings, and so on. | 117–90 |
B | Better: the assessed hospital building units, taking into account site selection, functional settings, flow organization, site environment, and so on, satisfy the requirement for spatial balance. | 89–80 |
C | Medium: in terms of site selection, functional settings, flow organization, site environment, and so on, the evaluated hospital building units essentially satisfy the requirement for spatial balance. | 79–70 |
D | General: in terms of siting, functional settings, flow organization, site environment, and so on, the spatial balance of the assessed hospital building units is average. | 69–60 |
E | Mediocre: in terms of site selection, functional settings, flow organization, site environment, and so on, the spatial balance of the assessed hospital building units is unsatisfactory and urgently needs to be improved. | 59–0 |
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Liu, Y.; Chen, L.; Qi, M.; Kong, D. Construction of a Spatial Equalization Assessment System for Medical Facilities. Buildings 2024, 14, 1265. https://doi.org/10.3390/buildings14051265
Liu Y, Chen L, Qi M, Kong D. Construction of a Spatial Equalization Assessment System for Medical Facilities. Buildings. 2024; 14(5):1265. https://doi.org/10.3390/buildings14051265
Chicago/Turabian StyleLiu, Yi, Lulu Chen, Mu Qi, and Dezheng Kong. 2024. "Construction of a Spatial Equalization Assessment System for Medical Facilities" Buildings 14, no. 5: 1265. https://doi.org/10.3390/buildings14051265